POS1272 EVALUATION OF DIAGNOSIS, TREATMENT AND OUTCOME RESULTS OF MIS-C PATIENTS
Authors: K. Ulu, Ş. Çağlayan, T. Coşkuner, R. E. Yigit, M. Çakan, B. Sözeri
Journal: Annals of the Rheumatic Diseases (2022)

Background SARS-COV-2 infection, which has become a pandemic worldwide, has led to various results, from mild clinical findings to severe respiratory failure. Multisystem inflammatory syndrome (MIS-C) in children is a rare but severe condition characterized by fever, inflammation, and multi-organ failure, caused by an overreaction of the immune system after SARS-CoV-2 infection. Objectives This study aims to report the clinical and laboratory findings, diagnostic methods, treatment regimens, and short-term follow-up results of patients diagnosed with MIS-C. Methods This is a retrospective observational study from a tertiary pediatric rheumatology center including patients (aged 1 month to 21 years) diagnosed with MIS-C between April 2020-December 2021. Demographic, clinical, laboratory results, and follow-up data were collected through the electronic patient record system and analyzed. Results Of the 110 patients included in the study, 67.2% (n=74) were male. Fever was a common finding in all. Macrophage activation syndrome (MAS) was dominant in 28.2% (n=31), while Kawasaki-like disease was observed in 40% of the patients. Gastrointestinal symptoms were found in 64.5% of the cases, rash in 40%, conjunctivitis in 35.5%, lymphadenopathy in 30%, hypotension in 27.3%, cardiac decompensation in 16.4%, bradycardia in 8.2%, neurological findings in 4.5%, and/or coronary artery pathology in 3.6% respectively. Included in the study, 63.6% had lymphopenia, 48.2% had hypoalbuminemia, and 39.1% had hyponatremia. Thirty-eight patients (34.5%) were followed up in the intensive care unit; 19 of them had MAS. Concomitant chronic disease was present in 21.8% of the patients. The mean hospital stay was 12±7.8 days. Hypotension and MAS were the most common indications for admission to the intensive care unit. Intravenous immunoglobulin treatment was applied to 87.2% of the cases, the steroid was given to 70.9%, and anakinra treatment was given to 27.3%, respectively. In the outpatient follow-up, it was determined that the coronary abnormalities had regressed entirely. While 97.3% of the cases recovered without sequelae, three died. Three patients who died had the comorbid disease. While there was no significant difference in terms of Kawasaki-like disease and gender in those followed up in the intensive care unit (p=0.25, p=0.81), D-dimer was higher, and the mean age was greater (p=0.08, p=0.02). No statistical correlation was found between those with Kawasaki-like disease regarding age and gender (p=0.058 p=0.068). Conclusion Multisystem inflammatory syndrome in children may lead to severe cardiac findings and intensive care requirements at admission and hospital follow-up. The majority of MIS-C-related findings resolve completely until discharge or in short-term follow-up. Although the pathogenesis and treatment plan of the disease has been largely clarified, follow-up studies are needed in terms of long-term prognosis and relapse probabilities. Disclosure of Interests None declared